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Seto Y, Nagao M, Iino T, Harada A, Murakami K, Miwa K, Shinohara M, Nishimori M, Yoshikawa S, Asakura J, Fujioka T, Ishida T, Hirata KI, Toh R. Impaired Cholesterol Uptake Capacity in Patients with Hypertriglyceridemia and Diabetes Mellitus. J Appl Lab Med 2024; 9:728-740. [PMID: 38574000 DOI: 10.1093/jalm/jfae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/06/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Although low high-density lipoprotein cholesterol (HDL-C) levels are a common metabolic abnormality associated with insulin resistance, their role in cardiovascular risk stratification remains controversial. Recently, we developed a simple, high-throughput, cell-free assay system to evaluate the "cholesterol uptake capacity (CUC)" as a novel concept for HDL functionality. In this study, we assessed the CUC in patients with hypertriglyceridemia and diabetes mellitus. METHODS The CUC was measured using cryopreserved serum samples from 285 patients who underwent coronary angiography or percutaneous coronary intervention between December 2014 and May 2019 at Kobe University Hospital. RESULTS The CUC was significantly lower in diabetic patients (n = 125) than in nondiabetic patients (93.0 vs 100.7 arbitrary units (A.U.), P = 0.002). Patients with serum triglyceride (TG) levels >150 mg/dL (n = 94) also had a significantly lower CUC (91.8 vs 100.0 A.U., P = 0.004). Furthermore, the CUC showed a significant inverse correlation with TG, hemoglobin A1c (Hb A1c), homeostasis model assessment of insulin resistance (HOMA-IR), and body mass index (BMI). Finally, the HDL-C/Apolipoprotein A1 (ApoA1) ratio, calculated as a surrogate index of HDL particle size, was significantly positively correlated with the CUC (r2 = 0.49, P < 0.001), but inversely correlated with TG levels (r2 = -0.30, P < 0.001). CONCLUSIONS The CUC decreased in patients with hypertriglyceridemia and diabetes mellitus, and HDL particle size was a factor defining the CUC and inversely correlated with TG levels, suggesting that impaired CUC in insulin-resistant states was partially due to the shift in HDL towards smaller particles. These findings provide a better understanding of the mechanisms underlying impaired HDL functionality.
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Affiliation(s)
- Yutaro Seto
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Manabu Nagao
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Takuya Iino
- Central Research Laboratories, Sysmex Corporation, Nishi-ku, Kobe, Japan
| | - Amane Harada
- Central Research Laboratories, Sysmex Corporation, Nishi-ku, Kobe, Japan
| | - Katsuhiro Murakami
- Central Research Laboratories, Sysmex Corporation, Nishi-ku, Kobe, Japan
| | - Keiko Miwa
- Central Research Laboratories, Sysmex Corporation, Nishi-ku, Kobe, Japan
| | - Masakazu Shinohara
- Division of Molecular Epidemiology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Makoto Nishimori
- Division of Molecular Epidemiology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Sachiko Yoshikawa
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Junko Asakura
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Tomoo Fujioka
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
- Division of Nursing Practice, Kobe University Graduate School of Health Sciences, Suma-ku, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Ryuji Toh
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
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Okami Y, Chan Q, Miura K, Kadota A, Elliott P, Masaki K, Okayama A, Okuda N, Yoshita K, Miyagawa N, Okamura T, Sakata K, Saitoh S, Sakurai M, Nakagawa H, Stamler (deceased) J, Ueshima H. Small High-Density Lipoprotein and Omega-3 Fatty Acid Intake Differentiates Japanese and Japanese-Americans: The INTERLIPID Study. J Atheroscler Thromb 2023; 30:884-906. [PMID: 36328528 PMCID: PMC10406687 DOI: 10.5551/jat.63762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/19/2022] [Indexed: 08/04/2023] Open
Abstract
AIM To identify the most differentiated serum lipids, especially concerning particle size and fractions, between Japanese living in Japan and Japanese-Americans in Hawaii, in the absence of possible genetic confounders, and cross-sectionally examine the associated modifiable lifestyle factors. METHODS Overall, 1,241 (aged 40-59 years) Japanese living in Japan and Japanese-Americans in Hawaii were included. We quantified 130 serum lipid profiles (VLDL 1-5, IDL, LDL 1-6, high-density lipoprotein [HDL] 1-4, and their subfractions) using Bruker's 1H-nuclear magnetic resonance spectrometer for the primary outcome. Modifiable lifestyle factors included body mass index (BMI), physical activity, alcohol and smoking habits, and 70 nutrient parameters. We evaluated the different lipids between the groups using partial least squares-discriminant analysis and association between extracted lipids and lifestyle factors using multivariable linear regression analysis. RESULTS Concentrations of HDL4, HDL with the smallest particle size, were lower in Japanese than in Japanese-Americans of both sexes. Higher fish-derived omega-3 fatty acid intake and lower alcohol intake were associated with lower HDL4 concentrations. A 1% higher kcal intake of total omega-3 fatty acids was associated with a 9.8-mg/dL lower HDL4. Fish-derived docosapentaenoic acid, eicosapentaenoic acid, and docosahexaenoic acid intake were inversely associated with HDL4 concentration. There was no relationship between country, sex, age, or BMI. CONCLUSIONS Japanese and Japanese-Americans can be differentiated based on HDL4 concentration. High fish intake among the Japanese may contribute to their lower HDL4 concentration. Thus, HDL particle size may be an important clinical marker for coronary artery diseases or a fish consumption biomarker.
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Affiliation(s)
- Yukiko Okami
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Queenie Chan
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Kamal Masaki
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Nagako Okuda
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Katsushi Yoshita
- Graduate School of Human Life and Ecology Division of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
| | - Naoko Miyagawa
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan
| | - Shigeyuki Saitoh
- School of Health Sciences, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa, Japan
| | | | - Hirotsugu Ueshima
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
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3
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Toh R. Fish-Derived Omega-3 Fatty Acids: Guardians of High-Density Lipoprotein? J Atheroscler Thromb 2023; 30:855-858. [PMID: 37032090 PMCID: PMC10406655 DOI: 10.5551/jat.ed231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Affiliation(s)
- Ryuji Toh
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Matsumoto E, Oniki K, Ota-Kontani A, Seguchi Y, Sakamoto Y, Kaneko T, Imafuku T, Maeda H, Watanabe H, Maruyama T, Ogata Y, Yoshida M, Harada-Shiba M, Saruwatari J, Ogura M. Additive Effects of Drinking Habits and a Susceptible Genetic Polymorphism on Cholesterol Efflux Capacity. J Atheroscler Thromb 2023; 30:23-38. [PMID: 35249931 PMCID: PMC9899708 DOI: 10.5551/jat.63277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/30/2022] [Indexed: 01/11/2023] Open
Abstract
AIMS High levels of high-density lipoprotein cholesterol (HDL-C) are not necessarily effective in preventing atherosclerotic cardiovascular disease, and cholesterol efflux capacity (CEC) has attracted attention regarding HDL functionality. We aimed to elucidate whether drinking habits are associated with CEC levels, while also paying careful attention to confounding factors including serum HDL-C levels, other life style factors, and rs671 (*2), a genetic polymorphism of the aldehyde dehydrogenase 2 (ALDH2) gene determining alcohol consumption habit. METHODS A cross-sectional study was performed in 505 Japanese male subjects who were recruited from a health screening program. Associations of HDL-C and CEC levels with drinking habits and ALDH2 genotypes were examined. RESULTS The genotype frequencies of ALDH2 *1/*1 (homozygous wild-type genotype), *1/*2 and *2/*2 (homozygous mutant genotype) were 55%, 37% and 8%, respectively. Both HDL-C and CEC levels were higher in ALDH2 *1/*1 genotype carriers than in *2 allele carriers. Although HDL-C levels were higher in subjects who had a drinking habit than in non-drinkers, CEC levels tended to be lower in subjects with ≥ 46 g/day of alcohol consumption than in non-drinkers. Furthermore, CEC levels tended to be lower in ALDH2 *1/*1 genotype carriers with a drinking habit of ≥ 46 g/day than non-drinkers, while for *2 allele carriers, CEC levels tended to be lower with a drinking habit of 23-45.9 g/day compared to no drinking habit. CONCLUSIONS Our results suggest that heavy drinking habits may tend to decrease CEC levels, and in the ALDH2 *2 allele carriers, even moderate drinking habits may tend to decrease CEC levels.
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Affiliation(s)
- Erika Matsumoto
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Ami Ota-Kontani
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Yuri Seguchi
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Sakamoto
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tetsuya Kaneko
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tadashi Imafuku
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hitoshi Maeda
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Ogata
- Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan
| | - Minoru Yoshida
- Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Junji Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masatsune Ogura
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
- Department of General Medical Science, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center, Togane, Japan
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Palumbo M, Giammanco A, Purrello F, Pavanello C, Mombelli G, Di Pino A, Piro S, Cefalù AB, Calabresi L, Averna M, Bernini F, Zimetti F, Adorni MP, Scicali R. Effects of PCSK9 inhibitors on HDL cholesterol efflux and serum cholesterol loading capacity in familial hypercholesterolemia subjects: a multi-lipid-center real-world evaluation. Front Mol Biosci 2022; 9:925587. [PMID: 35928226 PMCID: PMC9343790 DOI: 10.3389/fmolb.2022.925587] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/27/2022] [Indexed: 01/03/2023] Open
Abstract
Proprotein convertase subtilisin/kexin type 9 (PCSK9), beyond regulating LDL cholesterol (LDL-c) plasma levels, exerts several pleiotropic effects by modulating lipid metabolism in extrahepatic cells such as macrophages. Macrophage cholesterol homeostasis depends on serum lipoprotein functions, including the HDL capacity to promote cell cholesterol efflux (CEC) and the serum capacity to promote cell cholesterol loading (CLC). The aim of this observational study was to investigate the effect of PCSK9 inhibitors (PCSK9-i) treatment on HDL-CEC and serum CLC in patients with familial hypercholesterolemia (FH). 31 genetically confirmed FH patients were recruited. Blood was collected and serum isolated at baseline and after 6 months of PCSK9-i treatment. HDL-CEC was evaluated through the main pathways with a radioisotopic cell-based assay. Serum CLC was assessed fluorimetrically in human THP-1 monocyte-derived macrophages. After treatment with PCSK9-i, total cholesterol and LDL-c significantly decreased (−41.6%, p < 0.0001 and −56.7%, p < 0.0001, respectively). Total HDL-CEC was not different between patients before and after treatment. Conversely, despite no changes in HDL-c levels between the groups, ABCG1 HDL-CEC significantly increased after treatment (+22.2%, p < 0.0001) as well as HDL-CEC by aqueous diffusion (+7.8%, p = 0.0008). Only a trend towards reduction of ABCA1 HDL-CEC was observed after treatment. PCSK9-i significantly decreased serum CLC (−6.6%, p = 0.0272). This effect was only partly related to the reduction of LDL-c levels. In conclusion, PCSK9-i treatment significantly increased HDL-CEC through ABCG1 and aqueous diffusion pathways and reduced the serum CLC in FH patients. The favorable effect of PCSK9-i on functional lipid profile could contribute to the cardiovascular benefit of these drugs in FH patients.
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Affiliation(s)
| | - Antonina Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE)—University of Palermo, Palermo, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Chiara Pavanello
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
- Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Giuliana Mombelli
- Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Angelo Baldassare Cefalù
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE)—University of Palermo, Palermo, Italy
| | - Laura Calabresi
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Maurizio Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE)—University of Palermo, Palermo, Italy
| | - Franco Bernini
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, Parma, Italy
- *Correspondence: Francesca Zimetti,
| | - Maria Pia Adorni
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Yu XH, Tang CK. ABCA1, ABCG1, and Cholesterol Homeostasis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1377:95-107. [PMID: 35575923 DOI: 10.1007/978-981-19-1592-5_7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cholesterol is a major component of mammalian cell membranes and plays important structural and functional roles. However, excessive cholesterol accumulation is toxic to cells and constitutes the molecular basis for many diseases, especially atherosclerotic cardiovascular disease. Thus, cellular cholesterol is tightly regulated to maintain a homeostasis. Reverse cholesterol transport (RCT) is thought to be one primary pathway to eliminate excessive cholesterol from the body. The first and rate-limiting step of RCT is ATP-binding cassette (ABC) transports A1 (ABCA1)- and ABCG1-dependent cholesterol efflux. In the process, ABCA1 mediates initial transport of cellular cholesterol to apolipoprotein A-I (apoA-I) for forming nascent high-density lipoprotein (HDL) particles, and ABCG1 facilitates subsequent continued cholesterol efflux to HDL for further maturation. In this chapter, we summarize the roles of ABCA1 and ABCG1 in maintaining cellular cholesterol homoeostasis and discuss the underlying mechanisms by which they mediate cholesterol export.
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Affiliation(s)
- Xiao-Hua Yu
- Institute of Clinical Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Chao-Ke Tang
- Institute of Cardiovascular Disease, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
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The role of HDL- and non-HDL-related parameters in cell-cholesterol efflux capacity. Atherosclerosis 2022; 345:1-6. [DOI: 10.1016/j.atherosclerosis.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
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Umezawa A, Maruyama C, Endo Y, Suenaga Y, Shijo Y, Kameyama N, Sato A, Nishitani A, Ayaori M, Waki M, Teramoto T, Ikewaki K. Effects of Dietary Education Program for the Japan Diet on Cholesterol Efflux Capacity: A Randomized Controlled Trial. J Atheroscler Thromb 2021; 29:881-893. [PMID: 34024872 PMCID: PMC9174087 DOI: 10.5551/jat.62832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: Improving cholesterol efflux capacity (CEC) of high-density lipoprotein (HDL) has been regarded as a novel target for preventing cardiovascular disease. HDL reportedly has antioxidant properties which may contribute to its functions. We investigated changes in CEC with intake of the Japan Diet (JD) recommended by the Japan Atherosclerosis Society and the relationship of these changes to serum antioxidant concentrations.
Methods: A randomized parallel controlled clinical trial on JD intake was performed in Japanese patients with dyslipidemia. Ninety-eight participants were randomly divided into the JD (n=49) or the partial JD (PJD) (n=49) group. Nutrition education, based on each diet at baseline and at 3 months, was provided and the participants were followed up for 6 months.
Results: Mean CEC was 1.05 in total and correlated positively with HDL-cholesterol (p<0.001) at baseline. CEC did not change while oxygen radical absorbance capacity (ORAC) was decreased in both groups (p<0.001). Although serum total carotenoid increased in both groups, serum α-tocopherol decreased in the JD group as compared to the PJD group (p<0.05). CEC correlated positively with HDL ORAC at baseline (p=0.021) and with serum total carotenoid at 3 and 6 months (p=0.005, 0.035). Changes in CEC correlated positively with changes in HDL ORAC at 3 months and serum total tocopherol at 3 and 6 months (p<0.001).
Conclusion: CEC was not changed by JD education in Japanese patients with dyslipidemia who already had normal CEC at baseline. CEC was suggested to be positively associated with serum α- and γ-tocopherol and HDL ORAC.
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Affiliation(s)
- Ariko Umezawa
- Division of Food and Nutrition, Graduate School of Human Sciences and Design, Japan Women's University
| | - Chizuko Maruyama
- Division of Food and Nutrition, Graduate School of Human Sciences and Design, Japan Women's University.,Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University
| | - Yasuhiro Endo
- Division of Anti-aging, Department of Internal Medicine, National Defense Medical College
| | - Yumiko Suenaga
- Division of Anti-aging, Department of Internal Medicine, National Defense Medical College
| | - Yuri Shijo
- Division of Food and Nutrition, Graduate School of Human Sciences and Design, Japan Women's University
| | - Noriko Kameyama
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University
| | - Aisa Sato
- Division of Food and Nutrition, Graduate School of Human Sciences and Design, Japan Women's University
| | - Ai Nishitani
- Teikyo Academic Research Center, Teikyo University
| | | | | | - Tamio Teramoto
- Teikyo Academic Research Center, Teikyo University.,Teramoto Medical and Dental Clinic
| | - Katsunori Ikewaki
- Division of Anti-aging, Department of Internal Medicine, National Defense Medical College.,Tokorozawa Heart Center
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9
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Adorni MP, Ronda N, Bernini F, Zimetti F. High Density Lipoprotein Cholesterol Efflux Capacity and Atherosclerosis in Cardiovascular Disease: Pathophysiological Aspects and Pharmacological Perspectives. Cells 2021; 10:cells10030574. [PMID: 33807918 PMCID: PMC8002038 DOI: 10.3390/cells10030574] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Over the years, the relationship between high-density lipoprotein (HDL) and atherosclerosis, initially highlighted by the Framingham study, has been revealed to be extremely complex, due to the multiple HDL functions involved in atheroprotection. Among them, HDL cholesterol efflux capacity (CEC), the ability of HDL to promote cell cholesterol efflux from cells, has emerged as a better predictor of cardiovascular (CV) risk compared to merely plasma HDL-cholesterol (HDL-C) levels. HDL CEC is impaired in many genetic and pathological conditions associated to high CV risk such as dyslipidemia, chronic kidney disease, diabetes, inflammatory and autoimmune diseases, endocrine disorders, etc. The present review describes the current knowledge on HDL CEC modifications in these conditions, focusing on the most recent human studies and on genetic and pathophysiologic aspects. In addition, the most relevant strategies possibly modulating HDL CEC, including lifestyle modifications, as well as nutraceutical and pharmacological interventions, will be discussed. The objective of this review is to help understanding whether, from the current evidence, HDL CEC may be considered as a valid biomarker of CV risk and a potential pharmacological target for novel therapeutic approaches.
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Affiliation(s)
- Maria Pia Adorni
- Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
| | - Nicoletta Ronda
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (N.R.); (F.Z.)
| | - Franco Bernini
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (N.R.); (F.Z.)
- Correspondence:
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (N.R.); (F.Z.)
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10
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Vaisar T, Gordon JL, Wimberger J, Heinecke JW, Hinderliter AL, Rubinow DR, Girdler SS, Rubinow KB. Perimenopausal transdermal estradiol replacement reduces serum HDL cholesterol efflux capacity but improves cardiovascular risk factors. J Clin Lipidol 2021; 15:151-161.e0. [PMID: 33288437 PMCID: PMC7887026 DOI: 10.1016/j.jacl.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND The cardiovascular (CV) safety of estrogen replacement therapy (ERT) in perimenopausal women remains uncertain. Although exogenous estrogens increase HDL cholesterol (HDL-C), estrogen-mediated effects on alternative metrics of HDL that may better predict CV risk are unknown. OBJECTIVE To determine the effects of transdermal ERT on HDL composition and cholesterol efflux capacity (CEC), as well as the relationships between these metrics and CV risk factors. METHODS Fasting plasma samples were analyzed from 101 healthy, perimenopausal women randomized to receive either transdermal placebo or transdermal estradiol (100 μg/24 h) with intermittent micronized progesterone. At baseline and after 6 months of treatment, serum HDL CEC, HDL particle concentration, HDL protein composition, insulin resistance and brachial artery flow-mediated dilatation (FMD) were measured. RESULTS No difference between groups was found for change in plasma HDL-C (p = 0.69). Between-group differences were found for changes in serum HDL total CEC [median change from baseline -5.4 (-17.3,+8.4)% ERT group versus +5.8 (-6.3,+16.9)% placebo group, p = 0.01] and ABCA1-specific CEC [median change from baseline -5.3 (-10.7,+6.7)% ERT group versus +7.4 (-1.5,+18.1)% placebo group, p = 0.0002]. Relative to placebo, transdermal ERT led to reductions in LDL-C (p < 0.0001) and insulin resistance (p = 0.0002). An inverse correlation was found between changes in serum HDL total CEC and FMD (β = -0.26, p = 0.004). CONCLUSIONS Natural menopause leads to an increase in serum HDL CEC, an effect that is abrogated by transdermal ERT. However, transdermal ERT leads to favorable changes in major CV risk factors.
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Affiliation(s)
- Tomas Vaisar
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, 750 Republican St, Seattle WA 98109, USA
| | - Jennifer L Gordon
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, Chapel Hill, NC 27599, USA
| | - Jake Wimberger
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, 750 Republican St, Seattle WA 98109, USA
| | - Jay W Heinecke
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, 750 Republican St, Seattle WA 98109, USA
| | - Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, Chapel Hill, NC 27599, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, Chapel Hill, NC 27599, USA
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, Chapel Hill, NC 27599, USA
| | - Katya B Rubinow
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, 750 Republican St, Seattle WA 98109, USA.
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11
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Kostara CE, Ferrannini E, Bairaktari ET, Papathanasiou A, Elisaf M, Tsimihodimos V. Early Signs of Atherogenic Features in the HDL Lipidomes of Normolipidemic Patients Newly Diagnosed with Type 2 Diabetes. Int J Mol Sci 2020; 21:ijms21228835. [PMID: 33266469 PMCID: PMC7700318 DOI: 10.3390/ijms21228835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular disease (CVD) is the major cause of death in patients with type-2 diabetes mellitus (T2DM), although the factors that accelerate atherosclerosis in these patients are poorly understood. The identification of the altered quantity and quality of lipoproteins, closely related to atherogenesis, is limited in routine to a pattern of high triglycerides and low HDL-cholesterol (HDL-C) and in research as dysfunctional HDLs. We used the emerging NMR-based lipidomic technology to investigate compositional features of the HDLs of healthy individuals with normal coronary arteries, drug-naïve; recently diagnosed T2DM patients with normal coronary arteries; and patients with recent acute coronary syndrome. Patients with T2DM and normal serum lipid profiles even at diagnosis presented significant lipid alterations in HDL, characterized by higher triglycerides, lysophosphatidylcholine and saturated fatty acids; and lower cholesterol, phosphatidylcholine, phosphatidylethanolamine, sphingomyelin, plasmalogens and polyunsaturated fatty acids, an atherogenic pattern that may be involved in the pathogenesis of atherosclerosis. These changes are qualitatively similar to those found, more profoundly, in normolipidemic patients with established Coronary Heart Disease (CHD). We also conclude that NMR-based lipidomics offer a novel holistic exploratory approach for identifying and quantifying lipid species in biological matrixes in physiological processes and disease states or in disease biomarker discovery.
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Affiliation(s)
- Christina E. Kostara
- Laboratory of Clinical Chemistry, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (C.E.K.); (E.T.B.)
| | | | - Eleni T. Bairaktari
- Laboratory of Clinical Chemistry, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (C.E.K.); (E.T.B.)
| | - Athanasios Papathanasiou
- Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (A.P.); (M.E.)
| | - Moses Elisaf
- Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (A.P.); (M.E.)
| | - Vasilis Tsimihodimos
- Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (A.P.); (M.E.)
- Correspondence: ; Tel.: +30-2651007362
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12
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Cardiovascular Risk Factor Reduction in First Responders Resulting From an Individualized Lifestyle and Blood Test Program: A Randomized Controlled Trial. J Occup Environ Med 2020; 61:183-189. [PMID: 30475306 PMCID: PMC6416033 DOI: 10.1097/jom.0000000000001490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We tested the hypothesis that a lifestyle program would improve risk factors linked to cardiovascular disease (CVD) in first responders. METHODS A 1-year cluster-randomized controlled clinical trial in 10 cities. Participants were 175 first responders, with increased waist circumference and/or low levels of large (α1) high-density lipoprotein (HDL) particles. The intervention group received personalized online tools and access to telephonic coaching sessions. RESULTS At 1 year the intervention significantly reduced body weight (P = 0.004) and waist circumference (P = 0.002), increased α1 HDL (P = 0.01), and decreased triglyceride (P = 0.005) and insulin concentrations (P = 0.03). Program adherence was associated with weight loss (P = 0.0005) and increases in α1 HDL (P = 0.03). CONCLUSIONS In first responders, a personalized lifestyle intervention significantly improved CVD risk factors in proportion to program adherence. Changes in large HDL particles were more sensitive indicators of lifestyle changes than HDL-cholesterol measurement. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT03322046.
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13
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Ajala ON, Demler OV, Liu Y, Farukhi Z, Adelman SJ, Collins HL, Ridker PM, Rader DJ, Glynn RJ, Mora S. Anti-Inflammatory HDL Function, Incident Cardiovascular Events, and Mortality: A Secondary Analysis of the JUPITER Randomized Clinical Trial. J Am Heart Assoc 2020; 9:e016507. [PMID: 32799709 PMCID: PMC7660788 DOI: 10.1161/jaha.119.016507] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background High‐density lipoprotein (HDL) cholesterol has inverse association with cardiovascular disease. HDL possesses anti‐inflammatory properties in vitro, but it is unknown whether this may be protective in individuals with inflammation. Methods and Results The functional capacity of HDL to inhibit oxidation of oxidized low‐density lipoprotein (ie, the HDL inflammatory index; HII) was measured at baseline and 12 months after random allocation to rosuvastatin or placebo in a nested case‐control study of the JUPITER (Justification for the Use of Statins in Prevention: An Intervention Evaluating Rosuvastatin) trial. There were 517 incident cases of cardiovascular disease and all‐cause mortality compared to 517 age‐ and sex‐matched controls. Multivariable conditional logistic regression was used to examine associations of HII with events. Median baseline HII was 0.54 (interquartile range, 0.50–0.59). Twelve months of rosuvastatin decreased HII by a mean of 5.3% (95% CI, −8.9% to −1.7%; P=0.005) versus 1.3% (95% CI, −6.5% to 4.0%; P=0.63) with placebo (P=0.22 for between‐group difference). HII had a nonlinear relationship with incident events. Compared with the reference group (HII 0.5–1.0) with the lowest event rates, participants with baseline HII ≤0.5 had significantly increased risk of cardiovascular disease/mortality (adjusted hazard ratio, 1.53; 95% CI, 1.06–2.21; P=0.02). Furthermore, there was significant (P=0.002) interaction for HDL particle number with HII, such that having more HDL particles was associated with decreased risk only when HDL was anti‐inflammatory. Conclusions In JUPITER participants recruited on the basis of chronic inflammation, HII was associated with incident cardiovascular disease/mortality, with an optimal anti‐inflammatory HII range between 0.5 and 1.0. This nonlinear relationship of anti‐inflammatory HDL function with risk may account in part for the HDL paradox. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00239681.
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Affiliation(s)
- Oluremi N Ajala
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA
| | - Olga V Demler
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA
| | - Yanyan Liu
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA
| | - Zareen Farukhi
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA
| | | | | | - Paul M Ridker
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA.,Division of Cardiovascular Medicine Brigham and Women's Hospital Boston MA
| | - Daniel J Rader
- Department of Genetics University of Pennsylvania Philadelphia PA
| | - Robert J Glynn
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA
| | - Samia Mora
- Center for Lipid Metabolomics and Division of Preventive Medicine Brigham and Women's Hospital Boston MA.,Harvard Medical School Boston MA.,Division of Cardiovascular Medicine Brigham and Women's Hospital Boston MA
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14
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Morton RE, Liu Y. The lipid transfer properties of CETP define the concentration and composition of plasma lipoproteins. J Lipid Res 2020; 61:1168-1179. [PMID: 32591337 DOI: 10.1194/jlr.ra120000691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/24/2020] [Indexed: 01/22/2023] Open
Abstract
Cholesteryl ester transfer protein (CETP) facilitates the net transfer of cholesteryl esters (CEs) and TGs between lipoproteins, impacting the metabolic fate of these lipoproteins. Previous studies have shown that a CETP antibody can alter CETP's preference for CE versus TG as transfer substrate, suggesting that CETP substrate preference can be manipulated in vivo. Hamster and human CETPs have very different preferences for CE and TG. To assess the effect of altering CETP's substrate preference on lipoproteins in vivo, here, we expressed human CETP in hamsters. Chow-fed hamsters received adenoviruses expressing no CETP, hamster CETP, or human CETP. Plasma CETP mass increased 2-fold in both the hamster and human CETP groups. Although the animals expressing human CETP still had low levels of hamster CETP, the CE versus TG preference of their plasma CETP was similar to that of the human ortholog. Hamster CETP overexpression had little impact on lipoproteins. However, expression of human CETP reduced HDL up to 50% and increased VLDL cholesterol 2.5-fold. LDL contained 20% more CE, whereas HDL CE was reduced 40%, and TG increased 6-fold. The HDL3:HDL2 ratio increased from 0.32 to 0.60. Hepatic expression of three cholesterol-related genes (LDLR, SCARB1, and CYP7A1) was reduced up to 40%. However, HDL-associated CE excretion into feces was unchanged. We conclude that expression of human CETP in hamsters humanizes their lipoprotein profile with respect to the relative concentrations of VLDL, LDL, HDL, and the HDL3:HDL2 ratio. Altering the lipid substrate preference of CETP provides a novel approach for modifying plasma lipoproteins.
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Affiliation(s)
- Richard E Morton
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Yan Liu
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
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15
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de Lima-Junior JC, Virginio VWM, Moura FA, Bertolami A, Bertolami M, Coelho-Filho OR, Zanotti I, Nadruz W, de Faria EC, de Carvalho LSF, Sposito AC. Excess weight mediates changes in HDL pool that reduce cholesterol efflux capacity and increase antioxidant activity. Nutr Metab Cardiovasc Dis 2020; 30:254-264. [PMID: 31753789 DOI: 10.1016/j.numecd.2019.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/02/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIM Obesity-related decline in high-density lipoprotein (HDL) functions such as cholesterol efflux capacity (CEC) has supported the notion that this lipoprotein dysfunction may contribute for atherogenesis among obese patients. We investigated if potentially other HDL protective actions may be affected with weight gain and these changes may occur even before the obesity range in a cross-sectional analysis. METHODS AND RESULTS Lipid profile, body mass index (BMI), biochemical measurements, and carotid intima-media thickness (cIMT) were obtained in this cross-sectional study with 899 asymptomatic individuals. Lipoproteins were separated by ultracentrifugation and HDL physical-chemical characterization, CEC, antioxidant activity, anti-inflammatory activity, HDL-mediated platelet aggregation inhibition were measured in a randomly-selected subgroup (n = 101). Individuals with increased HDL-C had an attenuated increase in cIMT with elevation of BMI (interaction effect β = -0.054; CI 95% -0.0815, -0.0301). CEC, HDL-C, HDL size and HDL-antioxidant activity were negatively associated with cIMT. BMI was inversely correlated with HDL-mediated inhibition of platelet aggregation (Spearman's rho -0.157, p < 0.03) and CEC (Spearman's rho -0.32, p < 0.001), but surprisingly it was directly correlated with the antioxidant activity (Spearman's rho 0.194, p = 0.052). Thus, even in non-obese, non-diabetic individuals, increased BMI is associated with a wide change in protective functions of HDL, reducing CEC and increasing antioxidant activity. In these subjects, decreased HDL concentration, size or function are related to increased atherosclerotic burden. CONCLUSION Our findings demonstrate that in non-obese, non-diabetic individuals, the increasing values of BMI are associated with impaired protective functions of HDL and concomitant increase in atherosclerotic burden.
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Affiliation(s)
- Jose Carlos de Lima-Junior
- Laboratory of Atherosclerosis and Vascular Biology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Vitor W M Virginio
- Laboratory of Atherosclerosis and Vascular Biology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Filipe A Moura
- Laboratory of Atherosclerosis and Vascular Biology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil; Department of Cardiology, Brigham and Women's Hospital, Boston, New England, United States
| | - Adriana Bertolami
- Department of Dyslipidemia, Dante Pazzanese Cardiological Institute, São Paulo, Brazil
| | - Marcelo Bertolami
- Department of Dyslipidemia, Dante Pazzanese Cardiological Institute, São Paulo, Brazil
| | - Otavio R Coelho-Filho
- Department of Internal Medicine, Cardiology Division, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Ilaria Zanotti
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Wilson Nadruz
- Department of Internal Medicine, Cardiology Division, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Eliana Cotta de Faria
- Lipids Laboratory, Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Sao Paulo, Brazil
| | - Luiz Sergio F de Carvalho
- Laboratory of Atherosclerosis and Vascular Biology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil; Department of Internal Medicine, Cardiology Division, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Andrei C Sposito
- Laboratory of Atherosclerosis and Vascular Biology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil; Department of Internal Medicine, Cardiology Division, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil.
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16
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Advances in HDL: Much More than Lipid Transporters. Int J Mol Sci 2020; 21:ijms21030732. [PMID: 31979129 PMCID: PMC7037660 DOI: 10.3390/ijms21030732] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 01/07/2023] Open
Abstract
High Density Lipoprotein (HDL) particles, beyond serving as lipid transporters and playing a key role in reverse cholesterol transport, carry a highly variable number of proteins, micro-RNAs, vitamins, and hormones, which endow them with the ability to mediate a plethora of cellular and molecular mechanisms that promote cardiovascular health. It is becoming increasingly evident, however, that the presence of cardiovascular risk factors and co-morbidities alters HDLs cargo and protective functions. This concept has led to the notion that metrics other than HDL-cholesterol levels, such as HDL functionality and composition, may better capture HDL cardiovascular protection. On the other hand, the potential of HDL as natural delivery carriers has also fostered the design of engineered HDL-mimetics aiming to improve HDL efficacy or as drug-delivery agents with therapeutic potential. In this paper, we first provide an overview of the molecules known to be transported by HDL particles and mainly discuss their functions in the cardiovascular system. Second, we describe the impact of cardiovascular risk factors and co-morbidities on HDL remodeling. Finally, we review the currently developed HDL-based approaches.
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17
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Oshita T, Toh R, Nagano Y, Kuroda K, Nagasawa Y, Harada A, Murakami K, Kiriyama M, Yoshikawa K, Miwa K, Kubo T, Iino T, Nagao M, Irino Y, Hara T, Shinohara M, Otake H, Shinke T, Nakajima K, Ishida T, Hirata KI. Association of cholesterol uptake capacity, a novel indicator for HDL functionality, and coronary plaque properties: An optical coherence tomography-based observational study. Clin Chim Acta 2020; 503:136-144. [PMID: 31972150 DOI: 10.1016/j.cca.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cholesterol efflux from atherosclerotic lesion is a key function of high-density lipoprotein (HDL). Recently, we established a simple, high-throughput, cell-free assay to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as "cholesterol uptake capacity (CUC)". OBJECTIVE To clarify the cross-sectional relationship between CUC and coronary plaque properties. METHODS We enrolled 135 patients to measure CUC and assess the morphological features of angiographic stenosis by optical coherence tomography (OCT). We estimated the extent of the lipid-rich plaque by multiplying the mean lipid arc by lipid length (lipid index). The extent of the OCT-detected macrophage accumulation in the target plaque was semi-quantitatively estimated using a grading system. RESULTS Lipid-rich plaque lesions were identified in 125 patients (92.6%). CUC was inversely associated with the lipid index (R = -0.348, P < 0.0001). In addition, CUC was also inversely associated with macrophage score (R = -0.327, P < 0.0001). Conversely, neither circulating levels of HDL cholesterol nor apoA1 showed a similar relationship. CONCLUSIONS We demonstrated that CUC was inversely related to lipid-rich plaque burden and the extent of macrophage accumulation, suggesting that CUC could be useful for cardiovascular risk stratification.
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Affiliation(s)
- Toshihiko Oshita
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryuji Toh
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Yuichiro Nagano
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Kuroda
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshinori Nagasawa
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Amane Harada
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | | | - Maria Kiriyama
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | - Keiko Yoshikawa
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | - Keiko Miwa
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | - Takuya Kubo
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | - Takuya Iino
- Central Research Laboratories, Sysmex Corporation, Kobe, Japan
| | - Manabu Nagao
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiro Irino
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsuya Hara
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masakazu Shinohara
- Division of Epidemiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Katsuyuki Nakajima
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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18
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Hafiane A, Gasbarrino K, Daskalopoulou SS. The role of adiponectin in cholesterol efflux and HDL biogenesis and metabolism. Metabolism 2019; 100:153953. [PMID: 31377319 DOI: 10.1016/j.metabol.2019.153953] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/27/2022]
Abstract
Cholesterol efflux is the initial step in the reverse cholesterol transport pathway by which excess cholesterol in peripheral cells is exported and subsequently packaged into high-density lipoprotein (HDL) particles. Adiponectin is the most abundantly secreted adipokine that possesses anti-inflammatory and vasculoprotective properties via interaction with transmembrane receptors, AdipoR1 and AdipoR2. Evidence suggests that low levels of adiponectin may be a useful marker for atherosclerotic disease. A proposed anti-atherogenic mechanism of adiponectin involves its ability to promote cholesterol efflux. We performed a systematic review of the role of adiponectin in cholesterol efflux and HDL biogenesis, and of the proteins and receptors believed to be implicated in this process. Nineteen eligible studies (7 clinical, 11 fundamental, 1 clinical + fundamental) were identified through Ovid Medline, Ovid Embase, and Pubmed, that support the notion that adiponectin plays a key role in promoting ABCA1-dependent cholesterol efflux and in modulating HDL biogenesis via activation of the PPAR-γ/LXR-α signalling pathways in macrophages. AdipoR1 and AdipoR2 are suggested to also be implicated in this process, however the data are conflicting/insufficient to establish any firm conclusions. Once the exact mechanisms are unravelled, adiponectin may be critical in defining future treatment strategies directed towards increasing HDL functionality and ultimately reducing atherosclerotic disease.
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Affiliation(s)
- Anouar Hafiane
- Department of Medicine, Faculty of Medicine, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
| | - Karina Gasbarrino
- Department of Medicine, Faculty of Medicine, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
| | - Stella S Daskalopoulou
- Department of Medicine, Faculty of Medicine, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
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19
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Adorni MP, Zimetti F, Cangiano B, Vezzoli V, Bernini F, Caruso D, Corsini A, Sirtori CR, Cariboni A, Bonomi M, Ruscica M. High-Density Lipoprotein Function Is Reduced in Patients Affected by Genetic or Idiopathic Hypogonadism. J Clin Endocrinol Metab 2019; 104:3097-3107. [PMID: 30835274 DOI: 10.1210/jc.2018-02027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/26/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT Low testosterone levels are associated with an increased incidence of cardiovascular (CV) events, but the underlying biochemical mechanisms are not fully understood. The clinical condition of hypogonadism offers a unique model to unravel the possible role of lipoprotein-associated abnormalities in CV risk. In particular, the assessment of the functional capacities of high-density lipoproteins (HDLs) may provide insights besides traditional risk factors. DESIGN To determine whether reduced testosterone levels correlate with lipoprotein function, HDL cholesterol (HDL-C) efflux capacity (CEC) and serum cholesterol loading capacity (CLC). PARTICIPANTS Genetic and idiopathic hypogonadal patients (n = 20) and control subjects (n = 17). RESULTS Primary and secondary hypogonadal patients presented with lower HDL ATP-binding cassette transporter A1 (ABCA1)-, ATP-binding cassette transporter G1 (ABCG1)-, and aqueous diffusion-mediated CEC (-19.6%, -40.9%, and -12.9%, respectively), with a 16.2% decrement of total CEC. In the whole series, positive correlations between testosterone levels and both total HDL CEC (r2 = 0.359, P = 0.0001) and ABCG1 HDL CEC (r2 = 0.367, P = 0.0001) were observed. Conversely, serum CLC was markedly raised (+43%) in hypogonadals, increased, to a higher extent, in primary vs secondary hypogonadism (18.45 ± 2.78 vs 15.15 ± 2.10 µg cholesterol/mg protein) and inversely correlated with testosterone levels (r2 = 0.270, P = 0.001). HDL-C concentrations did not correlate with either testosterone levels, HDL CEC (total, ABCG1, and ABCA1) or serum CLC. CONCLUSIONS In hypogonadal patients, proatherogenic lipoprotein-associated changes are associated with lower cholesterol efflux and increased influx, thus offering an explanation for a potentially increased CV risk.
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Affiliation(s)
| | | | - Biagio Cangiano
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Laboratory of Endocrine and Metabolic Research and Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy
| | - Valeria Vezzoli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Laboratory of Endocrine and Metabolic Research and Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy
| | - Franco Bernini
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Donatella Caruso
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
- Multimedica Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy
| | - Cesare R Sirtori
- Centro Dislipidemie, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Cariboni
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Marco Bonomi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Laboratory of Endocrine and Metabolic Research and Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
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20
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Abstract
PURPOSE OF REVIEW Despite advances in the research on HDL composition (lipidomics and proteomics) and functions (cholesterol efflux and antioxidative capacities), the relationship between HDL compositional and functional properties is not fully understood. We have reviewed the recent literature on this topic and pointed out the difficulties which limit our understanding of HDL's role in cardiovascular disease (CVD). RECENT FINDINGS Though current findings strongly support that HDL has a significant role in CVD, the underlying mechanisms by which HDL mitigates CVD risk are not clear. This review focuses on studies that investigate the cell-cholesterol efflux capacity and the proteomic and lipidomic characterization of HDL and its subfractions especially those that analyzed the relationship between HDL composition and functions. SUMMARY Recent studies on HDL composition and HDL functions have greatly contributed to our understanding of HDL's role in CVD. A major problem in HDL research is the lack of standardization of both the HDL isolation and HDL functionality methods. Data generated by different methods often produce discordant results on the particle number, size, lipid and protein composition, and the various functions of HDL.
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Affiliation(s)
- Bela F Asztalos
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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21
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Asztalos BF, Horvath KV, Schaefer EJ. High-Density Lipoprotein Particles, Cell-Cholesterol Efflux, and Coronary Heart Disease Risk. Arterioscler Thromb Vasc Biol 2019; 38:2007-2015. [PMID: 30002062 DOI: 10.1161/atvbaha.118.311117] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective- The cell-cholesterol efflux capacity of HDL (high-density lipoprotein) is inversely associated with coronary heart disease risk. ABCA1 (ATP-binding cassette transporter A1) plays a crucial role in cholesterol efflux from macrophages to preβ-1-HDL. We tested the hypothesis that coronary heart disease patients have functionally abnormal preβ-1-HDL. Approach and Results- HDL cell-cholesterol efflux capacity via the ABCA1 and the SR-BI (scavenger receptor class B type I) pathways, HDL antioxidative capacity, apo (apolipoprotein) A-I-containing HDL particles, and inflammatory- and oxidative-stress markers were measured in a case-control study of 100 coronary heart disease cases and 100 sex-matched controls. There were significant positive correlations between ABCA1-dependent cholesterol efflux and the levels of small lipid-poor preβ-1 particles ( R2=0.535) and between SR-BI-dependent cholesterol efflux and the levels of large lipid-rich (α-1+α-2) HDL particles ( R2=0.712). Cases had significantly higher (87%) preβ-1 concentrations than controls, but the functionality of their preβ-1 particles (preβ-1 concentration normalized ABCA1-dependent efflux capacity) was significantly lower (-31%). Cases had significantly lower (-12%) mean concentration of large HDL particles, but the functionality of their particles (α-1+α-2 concentration normalized SR-BI-dependent efflux capacity) was significantly higher (22%) compared with that of controls. HDL antioxidative capacity was significantly lower (-16%) in cases than in controls. There were no significant correlations between either preβ-1 functionality or large HDL particle functionality with HDL antioxidative capacity or the concentrations of inflammatory- and oxidative-stress markers. Conclusions- HDL cell-cholesterol efflux capacity is significantly influenced by both the concentration and the functionality of specific HDL particles participating in cell-cholesterol efflux. Coronary heart disease patients have higher than normal preβ-1 concentrations with decreased functionality and lower than normal large HDL particle concentrations with enhanced functionality.
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Affiliation(s)
- Bela F Asztalos
- From the Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Katalin V Horvath
- From the Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Ernst J Schaefer
- From the Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
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22
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Bardagjy AS, Steinberg FM. Relationship Between HDL Functional Characteristics and Cardiovascular Health and Potential Impact of Dietary Patterns: A Narrative Review. Nutrients 2019; 11:E1231. [PMID: 31151202 PMCID: PMC6627343 DOI: 10.3390/nu11061231] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/25/2019] [Accepted: 05/27/2019] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular disease is a leading cause of death around the world. Overall diet quality and dietary behaviors are core contributors to metabolic health. While therapeutic targets have traditionally focused on levels of lipoprotein cholesterol when evaluating cardiovascular risk, current perspectives on high-density lipoprotein (HDL) have shifted to evaluating the functionality of this lipoprotein particle. Effects of diet on cardiovascular health are mediated through multiple pathways, but the impact on HDL composition and function deserves greater attention. Potential areas of investigation involve changes in particle characteristics, distribution, microRNA cargo, and other functional changes such as improvements to cholesterol efflux capacity. Various dietary patterns like the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet have beneficial effects on cardiovascular health and may prevent cardiovascular events. These healthful dietary patterns tend to be rich in plant-based foods, with cardiovascular benefits likely resulting from synergistic effects of the individual dietary components. The purpose of this review is to summarize current perspectives on selected functions of HDL particles and how various dietary patterns affect cardiovascular health biomarkers, with a focus on HDL functionality.
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Affiliation(s)
- Allison S Bardagjy
- Department of Nutrition and Graduate Group in Nutritional Biology, University of California, Davis, CA 95616, USA.
| | - Francene M Steinberg
- Department of Nutrition and Graduate Group in Nutritional Biology, University of California, Davis, CA 95616, USA.
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23
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Toh R. Assessment of HDL Cholesterol Removal Capacity: Toward Clinical Application. J Atheroscler Thromb 2019; 26:111-120. [PMID: 30542002 PMCID: PMC6365149 DOI: 10.5551/jat.rv17028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 10/11/2018] [Indexed: 12/15/2022] Open
Abstract
While there is a controversy regarding the causal relationship between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD), recent studies have demonstrated that the cholesterol efflux capacity (CEC) of HDL is associated with the incidence of CVD. However, there are several limitations to current assays of CEC. First, CEC measurements are not instantly applicable in clinical settings, because CEC assay methods require radiolabeled cholesterol and cultured cells, and these procedures are time consuming. Second, techniques to measure CEC are not standardized. Third, the condition of endogenous cholesterol donors would not be accounted for in the CEC assays. Recently, we established a simple, high-throughput, cell-free assay system to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as "cholesterol uptake capacity (CUC)". We demonstrated that CUC represents a residual cardiovascular risk in patients with optimal low-density lipoprotein cholesterol control independently of traditional risk factors, including HDL-C. Establishing reproducible approaches for the cholesterol removal capacity of HDL is required to validate the impact of dysfunctional HDL on cardiovascular risk stratification in the "real world".
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Affiliation(s)
- Ryuji Toh
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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24
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Yu XH, Zhang DW, Zheng XL, Tang CK. Cholesterol transport system: An integrated cholesterol transport model involved in atherosclerosis. Prog Lipid Res 2018; 73:65-91. [PMID: 30528667 DOI: 10.1016/j.plipres.2018.12.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/30/2018] [Accepted: 12/01/2018] [Indexed: 02/07/2023]
Abstract
Atherosclerosis, the pathological basis of most cardiovascular disease (CVD), is closely associated with cholesterol accumulation in the arterial intima. Excessive cholesterol is removed by the reverse cholesterol transport (RCT) pathway, representing a major antiatherogenic mechanism. In addition to the RCT, other pathways are required for maintaining the whole-body cholesterol homeostasis. Thus, we propose a working model of integrated cholesterol transport, termed the cholesterol transport system (CTS), to describe body cholesterol metabolism. The novel model not only involves the classical view of RCT but also contains other steps, such as cholesterol absorption in the small intestine, low-density lipoprotein uptake by the liver, and transintestinal cholesterol excretion. Extensive studies have shown that dysfunctional CTS is one of the major causes for hypercholesterolemia and atherosclerosis. Currently, several drugs are available to improve the CTS efficiently. There are also several therapeutic approaches that have entered into clinical trials and shown considerable promise for decreasing the risk of CVD. In recent years, a variety of novel findings reveal the molecular mechanisms for the CTS and its role in the development of atherosclerosis, thereby providing novel insights into the understanding of whole-body cholesterol transport and metabolism. In this review, we summarize the latest advances in this area with an emphasis on the therapeutic potential of targeting the CTS in CVD patients.
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Affiliation(s)
- Xiao-Hua Yu
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Medical Research Experiment Center, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, Hunan 421001, China
| | - Da-Wei Zhang
- Department of Pediatrics and Group on the Molecular and Cell Biology of Lipids, University of Alberta, Alberta, Canada
| | - Xi-Long Zheng
- Department of Biochemistry and Molecular Biology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Health Sciences Center, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada
| | - Chao-Ke Tang
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Medical Research Experiment Center, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, Hunan 421001, China.
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25
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Dergunov AD, Litvinov DY, Bazaeva EV, Dmitrieva VG, Nosova EV, Rozhkova AV, Dergunova LV. Relation of High-Density Lipoprotein Charge Heterogeneity, Cholesterol Efflux Capacity, and the Expression of High-Density Lipoprotein-Related Genes in Mononuclear Cells to the HDL-Cholesterol Level. Lipids 2018; 53:979-991. [DOI: 10.1002/lipd.12104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/12/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Alexander D. Dergunov
- National Research Centre for Preventive Medicine; 10, Petroverigsky Street, 101990 Moscow Russia
| | - Dmitry Y. Litvinov
- National Research Centre for Preventive Medicine; 10, Petroverigsky Street, 101990 Moscow Russia
| | - Ekaterina V. Bazaeva
- National Research Centre for Preventive Medicine; 10, Petroverigsky Street, 101990 Moscow Russia
| | - Veronika G. Dmitrieva
- National Research Centre for Preventive Medicine; 10, Petroverigsky Street, 101990 Moscow Russia
- Institute of Molecular Genetics of the Russian Academy of Sciences, 2, Kurchatov Square, 123182; Moscow Russia
| | - Elena V. Nosova
- Institute of Molecular Genetics of the Russian Academy of Sciences, 2, Kurchatov Square, 123182; Moscow Russia
| | - Alexandra V. Rozhkova
- Institute of Molecular Genetics of the Russian Academy of Sciences, 2, Kurchatov Square, 123182; Moscow Russia
| | - Liudmila V. Dergunova
- Institute of Molecular Genetics of the Russian Academy of Sciences, 2, Kurchatov Square, 123182; Moscow Russia
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26
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Geller AS, Polisecki EY, Diffenderfer MR, Asztalos BF, Karathanasis SK, Hegele RA, Schaefer EJ. Genetic and secondary causes of severe HDL deficiency and cardiovascular disease. J Lipid Res 2018; 59:2421-2435. [PMID: 30333156 DOI: 10.1194/jlr.m088203] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/13/2018] [Indexed: 02/07/2023] Open
Abstract
We assessed secondary and genetic causes of severe HDL deficiency in 258,252 subjects, of whom 370 men (0.33%) and 144 women (0.099%) had HDL cholesterol levels <20 mg/dl. We excluded 206 subjects (40.1%) with significant elevations of triglycerides, C-reactive protein, glycosylated hemoglobin, myeloperoxidase, or liver enzymes and men receiving testosterone. We sequenced 23 lipid-related genes in 201 (65.3%) of 308 eligible subjects. Mutations (23 novel) and selected variants were found at the following gene loci: 1) ABCA1 (26.9%): 2 homozygotes, 7 compound or double heterozygotes, 30 heterozygotes, and 2 homozygotes and 13 heterozygotes with variants rs9282541/p.R230C or rs111292742/c.-279C>G; 2) LCAT (12.4%): 1 homozygote, 3 compound heterozygotes, 13 heterozygotes, and 8 heterozygotes with variant rs4986970/p.S232T; 3) APOA1 (5.0%): 1 homozygote and 9 heterozygotes; and 4) LPL (4.5%): 1 heterozygote and 8 heterozygotes with variant rs268/p.N318S. In addition, 4.5% had other mutations, and 46.8% had no mutations. Atherosclerotic cardiovascular disease (ASCVD) prevalence rates in the ABCA1, LCAT, APOA1, LPL, and mutation-negative groups were 37.0%, 4.0%, 40.0%, 11.1%, and 6.4%, respectively. Severe HDL deficiency is uncommon, with 40.1% having secondary causes and 48.8% of the subjects sequenced having ABCA1, LCAT, APOA1, or LPL mutations or variants, with the highest ASCVD prevalence rates being observed in the ABCA1 and APOA1 groups.
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Affiliation(s)
- Andrew S Geller
- Boston Heart Diagnostics, Framingham, MA 01702.,Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA 02111
| | | | | | - Bela F Asztalos
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA 02111
| | | | - Robert A Hegele
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA 02111
| | - Ernst J Schaefer
- Boston Heart Diagnostics, Framingham, MA 01702 .,Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA 02111
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27
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Abstract
PURPOSE OF REVIEW The inverse association between HDL cholesterol (HDL-C) and cardiovascular disease (CVD) has been unequivocally proven in the past several decades. However, some interventions aiming to increase HDL-C failed to reduce CVD risk. HDL is structurally and functionally complex and HDL-associated metrics other than HDL-C, such as the concentration, composition, and functionality of HDL particles, have been considered as better determinants of CVD risk. A large body of recent research has addressed changes in HDL functions and HDL subpopulations in CVD with the goal of discovering novel and reliable biomarkers and targets for the treatment or prevention of CVD. RECENT FINDINGS We have reviewed recent findings on HDL composition, HDL particle concentrations, and cell-cholesterol efflux capacity that have lately contributed to our understanding of HDL's role in CVD. SUMMARY We point out that a major problem in HDL research is the lack of standardization of HDL assays that has led to discrepancies among studies. Therefore, there is a need for new standardized assays that capture the complexities of key HDL parameters.
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Affiliation(s)
- Katrin Niisuke
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA
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28
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Rubinow KB, Vaisar T, Chao JH, Heinecke JW, Page ST. Sex steroids mediate discrete effects on HDL cholesterol efflux capacity and particle concentration in healthy men. J Clin Lipidol 2018; 12:1072-1082. [PMID: 29793828 DOI: 10.1016/j.jacl.2018.04.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Exogenous testosterone decreases serum concentrations of high-density lipoprotein cholesterol (HDL-C) in men, but whether this alters cardiovascular risk is uncertain. OBJECTIVE To investigate the effects of testosterone and estradiol on HDL particle concentration (HDL-Pima) and metrics of HDL function. METHODS We enrolled 53 healthy men, 19 to 55 years of age, in a double-blinded, placebo-controlled, randomized trial. Subjects were rendered medically castrate using the GnRH receptor antagonist acyline and administered either (1) placebo gel, (2) low-dose transdermal testosterone gel (1.62%, 1.25 g), (3) full replacement dose testosterone gel (1.62%, 5 g) or (4) full replacement dose testosterone gel together with an aromatase inhibitor for 4 weeks. At baseline and end of treatment, serum HDL total macrophage and ABCA1-specific cholesterol efflux capacity (CEC), HDL-Pima and size, and HDL protein composition were determined. RESULTS Significant differences in serum HDL-C were observed with treatment across groups (P = .01 in overall repeated measures ANOVA), with increases in HDL-C seen after both complete and partial testosterone deprivation. Medical castration increased total HDL-Pima (median [interquartile range] 19.1 [1.8] nmol/L at baseline vs 21.3 [3.1] nmol/L at week 4, P = .006). However, corresponding changes in total macrophage CEC and ABCA1-specific CEC were not observed. Change in serum 17β-estradiol concentration correlated with change in total macrophage CEC (β = 0.33 per 10 pg/mL change in serum 17β-estradiol, P = .03). CONCLUSIONS Testosterone deprivation in healthy men leads to a dissociation between changes in serum HDL-C and HDL CEC. Changes in serum HDL-C specifically due to testosterone exposure may not reflect changes in HDL function.
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Affiliation(s)
- Katya B Rubinow
- Center for Research in Reproduction and Contraception, Seattle, WA, USA; Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | - Tomas Vaisar
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jing H Chao
- Center for Research in Reproduction and Contraception, Seattle, WA, USA
| | - Jay W Heinecke
- Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Stephanie T Page
- Center for Research in Reproduction and Contraception, Seattle, WA, USA; Diabetes Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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29
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Brassard D, Arsenault BJ, Boyer M, Bernic D, Tessier-Grenier M, Talbot D, Tremblay A, Levy E, Asztalos B, Jones PJH, Couture P, Lamarche B. Saturated Fats from Butter but Not from Cheese Increase HDL-Mediated Cholesterol Efflux Capacity from J774 Macrophages in Men and Women with Abdominal Obesity. J Nutr 2018; 148:573-580. [PMID: 29659963 PMCID: PMC7328473 DOI: 10.1093/jn/nxy014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/16/2018] [Indexed: 12/27/2022] Open
Abstract
Background Recent evidence suggests that the association between dietary saturated fatty acids (SFAs) and coronary artery disease risk varies according to food sources. How SFAs from butter and cheese influence HDL-mediated cholesterol efflux capacity (CEC), a key process in reverse cholesterol transport, is currently unknown. Objective In a predefined secondary analysis of a previously published trial, we have examined how diets rich in SFAs from either cheese or butter influence HDL-mediated CEC, compared with diets rich in either monounsaturated fatty acids (MUFAs) or polyunsaturated fatty acids (PUFAs). Methods In a randomized crossover controlled consumption trial, 46 men and women with abdominal obesity consumed 5 isocaloric diets, each for 4 wk. Two diets were rich in SFAs either from cheese (CHEESE) or butter (BUTTER) [12.4-12.6% of energy (%E) as SFAs, 32%E as fat, 52%E as carbohydrates]. In 2 other diets, SFAs (5.8%E) were replaced with either MUFAs from refined olive oil (MUFA) or PUFAs from corn oil (PUFA). Finally, a lower fat and carbohydrate diet was used as a control (5.8%E as SFAs, 25.0%E as fat, 59%E as carbohydrates; CHO). Post-diet HDL-mediated CEC was determined ex vivo using radiolabelled J774 macrophages incubated with apolipoprotein B-depleted serum from the participants. Results Mean (±SD) age was 41.4 ± 14.2 y, and waist circumference was 107.6 ± 11.5 cm in men and 94.3 ± 12.4 cm in women. BUTTER and MUFA increased HDL-mediated CEC compared with CHEESE (+4.3%, P = 0.026 and +4.7%, P = 0.031, respectively). Exploring the significant diet × sex interaction (P = 0.044) revealed that the increase in HDL-mediated CEC after BUTTER compared with CHEESE was significant among men (+6.0%, P = 0.047) but not women (+2.9%, P = 0.19), whereas the increase after MUFA compared with CHEESE was significant among women (+9.1%, P = 0.008) but not men (-0.6%, P = 0.99). Conclusion These results provide evidence of a food matrix effect modulating the impact of dairy SFAs on HDL-mediated CEC with potential sex-related differences that deserve further investigation. This trial was registered at clinicaltrials.gov as NCT02106208.
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Affiliation(s)
- Didier Brassard
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Benoît J Arsenault
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Marjorie Boyer
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Daniela Bernic
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Maude Tessier-Grenier
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Denis Talbot
- Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Angelo Tremblay
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Emile Levy
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Bela Asztalos
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Peter JH Jones
- Richardson Centre for Functional Foods and Nutraceuticals (RCFFN), University of Manitoba, Winnipeg, Canada
| | - Patrick Couture
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada
| | - Benoît Lamarche
- Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ) and Department of Medicine, Department of Social and Preventive Medicine, CHU de Quebec Research Center, and Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada,Address correspondence to BL (e-mail: )
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30
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Meeusen JW. Comparing Measures of HDL: On the Right Path with the Wrong Map. Clin Chem 2018; 64:424-426. [PMID: 29301750 DOI: 10.1373/clinchem.2017.284208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Jeffrey W Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
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31
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Egom EE, Shiwani HA, Pharithi RB, Canning R, Khan B, Hiani YE, Maher V. Dynamic changes of the composition of plasma HDL particles in patients with cardiac disease: Spotlight on sphingosine-1-phosphate/serum amyloid A ratio. Clin Exp Pharmacol Physiol 2017; 45:319-325. [DOI: 10.1111/1440-1681.12888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 10/26/2017] [Accepted: 10/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Emmanuel E Egom
- Department of Cardiology; The Adelaide and Meath Hospital Dublin; Incorporating the National Children Hospital; Dublin Ireland
| | - Haaris A Shiwani
- Department of Clinical Medicine; Education Division; Trinity College Dublin; The University of Dublin; Dublin Ireland
| | - Rebabonye B Pharithi
- Department of Cardiology; The Adelaide and Meath Hospital Dublin; Incorporating the National Children Hospital; Dublin Ireland
| | | | - Barkat Khan
- Department of Cardiology; The Adelaide and Meath Hospital Dublin; Incorporating the National Children Hospital; Dublin Ireland
| | - Yassine El Hiani
- Department of Physiology and Biophysics; Dalhousie University; Halifax Canada
| | - Vincent Maher
- Department of Cardiology; The Adelaide and Meath Hospital Dublin; Incorporating the National Children Hospital; Dublin Ireland
- Department of Clinical Medicine; Education Division; Trinity College Dublin; The University of Dublin; Dublin Ireland
- Institute of Technology Tallaght; Dublin Ireland
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32
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Matera R, Horvath KV, Nair H, Schaefer EJ, Asztalos BF. HDL Particle Measurement: Comparison of 5 Methods. Clin Chem 2017; 64:492-500. [PMID: 29203475 DOI: 10.1373/clinchem.2017.277632] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/15/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND HDL cell cholesterol efflux capacity has been documented as superior to HDL cholesterol (HDL-C) in predicting cardiovascular disease risk. HDL functions relate to its composition. Compositional assays are easier to perform and standardize than functional tests and are more practical for routine testing. Our goal was to compare measurements of HDL particles by 5 different separation methods. METHODS HDL subfractions were measured in 98 samples using vertical auto profiling (VAP), ion mobility (IM), nuclear magnetic resonance (NMR), native 2-dimensional gel electrophoresis (2D-PAGE), and pre-β1-ELISA. VAP measured cholesterol in large HDL2 and small HDL3; IM measured particle number directly in large, intermediate, and small HDL particles; NMR measured lipid signals in large, medium, and small HDL; 2D-PAGE measured apolipoprotein (apo) A-I in large (α1), medium (α2), small (α3-4), and pre-β1 HDL particles; and ELISA measured apoA-I in pre-β1-HDL. The data were normalized and compared using Passing-Bablok, Lin concordance, and Bland-Altman plot analyses. RESULTS With decreasing HDL-C concentration, NMR measured a gradually lower percentage of large HDL, compared with IM, VAP, and 2D-PAGE. In the lowest HDL-C tertile, NMR measured 8% of large HDL, compared with IM, 22%; VAP, 20%; and 2D-PAGE, 18%. There was strong discordance between 2D-PAGE and NMR in measuring medium HDL (R2 = 0.356; rc = 0.042) and small HDL (R2 = 0.376; rc = 0.040). The 2D-PAGE assay measured a significantly higher apoA-I concentration in pre-β1-HDL than the pre-β1-ELISA (9.8 vs 1.6 mg/dL; R2 = 0.246; rc = 0.130). CONCLUSIONS NMR agreed poorly with the other methods in measuring large HDL, particularly in low HDL-C individuals. Similarly, there was strong discordance in pre-β1-HDL measurements between the ELISA and 2D-PAGE assays.
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Affiliation(s)
- Robert Matera
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Katalin V Horvath
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, MA.,Boston Heart Diagnostics, Framingham, MA
| | - Hari Nair
- Boston Heart Diagnostics, Framingham, MA
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, MA.,Boston Heart Diagnostics, Framingham, MA
| | - Bela F Asztalos
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, MA; .,Boston Heart Diagnostics, Framingham, MA
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33
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Abstract
PURPOSE OF REVIEW Epidemiological and clinical studies link low levels of HDL cholesterol (HDL-C) with increased risk of atherosclerotic cardiovascular disease (CVD). However, genetic polymorphisms linked to HDL-C do not associate consistently with CVD risk, and randomized clinical studies of drugs that elevate HDL-C via different mechanisms failed to reduce CVD risk in statin-treated patients with established CVD. New metrics that capture HDL's proposed cardioprotective effects are therefore urgently needed. RECENT FINDINGS Recent studies demonstrate cholesterol efflux capacity (CEC) of serum HDL (serum depleted of cholesterol-rich atherogenic lipoproteins) is an independent and better predictor of incident and prevalent CVD risk than HDL-C. However, it remains unclear whether therapies that increase CEC are cardioprotective. Other key issues are the impact of HDL-targeted therapies on HDL particle size and concentration and the relationship of those changes to CEC and cardioprotection. SUMMARY It is time to end the clinical focus on HDL-C and to understand how HDL's function, protein composition and size contribute to CVD risk. It will also be important to link variations in function and size to HDL-targeted therapies. Developing new metrics for quantifying HDL function, based on better understanding HDL metabolism and macrophage CEC, is critical for achieving these goals.
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Affiliation(s)
- Graziella E. Ronsein
- Departamento de Bioquímica, Instituto de Química,
Universidade de São Paulo, Brazil
| | - Jay W. Heinecke
- Department of Medicine, University of Washington, Seattle, WA
98109
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